That is a 45% increase in fasting glucose in less than 2 weeks. What the heck is going on here?

Five important points:
1. DIET: My meals have been absolutely identical every day during these two weeks. For breakfast I have a "health shake" made with 1 banana, kale juice, 1 tbsp unsalted peanut butter, 1/2 tsp spirulina, 1/2 tsp goji powder, 1/2 tsp maca powder, 1/2 tsp acai powder, and 1/2 tsp cherry powder. For lunch I always eat 2 cups of a blended soup containing kale, peas, broccoli, potato, onion, garlic, nutritional yeast, ground flax, dried dill weed, pepper, and salt (ordered by weight). I eat the soup with a 1/2 cup of raw shredded kale and 1/2 cup of alfalfa sprouts, with some ground flax and nutritional yeast sprinkled on top. During the day I usually eat two pieces of fruit (usually an apple, orange, or watermelon) and a handful of homemade trail mix (raw cashews, pumpkin seeds, almonds, filberts, goji berries, dates, etc.). For dinner I usually simply repeat the lunch. And that's it. No sodas. No alcohol. No fruit juices or candy. The total caloric intake always hovers around 1,500 and contains a fairly even percent distribution between fat, starch, sugar, fiber, and protein.
2. DRUGS: Three days ago I started taking Seroquel and Xanax at bedtime, .25 mg and .5 mg, respectively, to treat bipolar type II and anxiety.
3. WEIGHT: During the term of the reported blood glucose levels, my weight DROPPED 22 pounds, from 243 to 231. I've lost 40 pounds total since July 15th.
4. EXERCISE: I do not exercise at all and haven't for several months.
5. I do not and have never smoked.

Here's my basic question: Since diet and exercise are serving as natural controls here (I eat the same thing and don't exercise), what the heck is causing my blood glucose levels to RISE!? I thought that my diet and the associated weight loss would LOWER my fasting blood glucose levels. What is going on?

Thank you for your advice.

Information about me:
I am a 26-year old male. My father has type II diabetes, but only developed it in his 70's after becoming morbidly obese. I haven't checked my blood pressure in a while, but for most of my life it has tested in the pre-hypertensive range. My brother (24 year old smoker and drinker) has hypertension but he's rail thin.

Just so responding community members know, I have already reviewed this link regarding Seroquel and diabetes risk. Certainly it is plausible that the past couple of days my levels have risen more dramatically because of the Seroquel. But that doesn't at all explain the other readings, which have been steadily increasing for two weeks even in the absence of Seroquel. I'm happy to provide any further information needed to help you give advice or recommendations. Thanks again, Mike.posted by mmorelli at 11:48 PM on September 22, 2012

Type 2 here.

Well, I'm not sure that 40 mg/dl over 11 days is really enough data to draw a strong conclusion from. There's normally a lot of variability in fasting BG, which is why tests like A1C are used diagnostically.

That said, it's well known that dieting has an effect on metabolism that frustrates dieters. Your metabolism slows down to conserve energy, as if you were a plains hominid in a starvation year. So what may be happening here is that you simply aren't processing the glucose as quickly as before. Your body will take months to adjust from the loss of 40 pounds over three months -- if not years. Give it some time to stabilize!

I think I would suggest that you try exercise, regardless, since becoming more active -- in fact, choosing an active lifestyle in many small ways, not just "exercising" -- is going to be critical in maintaining your weight loss over the long term. Then do another couple weeks of the chart and see how that plays out.

Bottom line, this isn't an exact science, in that the relationship between various external things like diet and exercise is general rather than direct and specific. Don't expect it to be this deterministic.posted by dhartung at 11:54 PM on September 22, 2012 [3 favorites]

Thank you dhartung. I did not consider that the rapid weight loss might be playing a role. Appreciate the comments.posted by mmorelli at 11:59 PM on September 22, 2012

Fasting blood glucose is a bullshit measure. It's the most likely time to be affected by dawn phenomenon, when your liver starts dumping glucose before you wake. Changes in schedule can mess with morning sugar levels.

Also note caloric restriction, if not deliberately countered by exercise, will lead to less movement during the day which could lead to increased insulin resistance. We're talking about unconscious motions for the most part, like rocking or tapping your foot while sitting, so it's possible your low activity level is now even lower due to dieting.

Sampling much more heavily (10x/day) for a few days per month is more informative than 1 time point per day. If you are becoming diabetic, you will see it first in post-meal measurements. If you are really concerned, go get a glucose tolerance test, which will tell you whether your glucose disposal ability is impaired.posted by benzenedream at 12:05 AM on September 23, 2012

benzenedream, thank you for your suggestion. I test post-prandial levels every day as well, but I do not record them because they're always in the 150 range. I usually test about 3x per day, depending on how much my fingers hurt from previous lancet sticks. Tonight, before dinner, my level was 98. An hour after dinner, it was 155. I had the kale soup and some watermelon.

I'll take the "more exercise, idiot" advice to heart (I added the idiot part because, well, its freaking true).posted by mmorelli at 12:18 AM on September 23, 2012

To quote Wikipedia citing the NIH,

Normal Human Glucose Blood Test results should be 70 - 130 (mg/dL) before meals, and less than 180 mg/dL after meals (as measured by a blood glucose monitor).⁽⁵⁾

You probably should not freak out until you start getting readings outside of the normal range. Though exercise is always advisable, of course.posted by XMLicious at 12:51 AM on September 23, 2012

Agree that while there could be things here affecting your fasting BG, you really don't have enough data and nothing to worry about now. Keep in mind the accuracy standard for BG monitors is within 20% (of a lab standard) 95% of the time. It is not an exact measure. Your BG could have in fact not varied much at all during this time period and you still could have come up with this range of readings.posted by freejinn at 4:07 AM on September 23, 2012

Are you seeing a doctor? These all seem like questions for a medical professional, not an internet list. Has a doctor advised you to monitor your blood glucose levels and blood pressure, or are you doing this on your own?posted by mermayd at 5:24 AM on September 23, 2012 [2 favorites]

WEIGHT: During the term of the reported blood glucose levels, my weight DROPPED 22 pounds, from 243 to 231
22 or 12? 12 in 2 weeks is extreme, particularly if you're not exercising . Rough estimates based on the information provided, you should have lost around 5lbs in those 2 weeks, but other factors could make the difference up to 12 but not 22 IMO. If you really have lost 22lbs in 2 weeks you should see a doctor immediately.

My guess would be dehydration, it makes your blood more concentrated which would give you an increased reading and would account for the extra weight loss (assuming 12lbs not 22lbs - if you'd 17-18lbs of fluid I would think you'd be noticing symptoms!)posted by missmagenta at 5:45 AM on September 23, 2012

I say this as someone who knows next-to-nothing about blood glucose levels, so take this with a grain of salt, but...is it possible the sugar in the fruits could be having this effect on you? I know that smoothies made with bananas can be quite sugary, and dates and watermelon are both extremely high in sugar. I'm almost-vegan as well and have found that drinking green smoothies made with bananas and without protein powder can leave me feeling shaky a few hours later. Not sure if that would affect your fasting glucose, though.posted by indognito at 6:43 AM on September 23, 2012

If you are trying to control blood sugar, I suggest you add some exercise to the mix. Also, this is probably a question you should be asking your doctor.

I know that seroquel is prescribed for bipolar II (in my case back in the day to help my sleep) but in my humble opinion there are better meds. If those are the only two meds you are taking for your bipolar I am seriously scratching my head as lamictal is gold standard for type II for most people, and seroquel is an antipsychotic, not a mood stabilizer.

Wait, you've lost 40 pounds in a little over 2 months? That's neither healthy nor sustainable (high likelihood of a rebound). Talk to a doctor.posted by curious nu at 8:01 AM on September 23, 2012 [1 favorite]

St. Alia of the Bunnies, thanks for writing. I took Lamictal for over a year and always experienced negative side-effects which overshadowed the benefits. Aside from this blood sugar issue (which may not even be related), my current med combo works pretty well.

Mermayd, I appreciate what you're saying, but (and take this for the anecdotal comment that it is) Metafilter respondents typically "get it right" when it comes to medical questions that do not require PET, CAT, or MRI scans. It simply isn't that difficult to figure out whats wrong with someone after they've explained their symptoms. I go to doctors all the time, but they do not have a monopoly on accurate diagnosis. Half the time I walk into a doctor with a stack of blog posts and forum responses and he flips through them and says, "Well, these are correct! Why'd ya come here if you already knew all this stuff?"

Missmagenta, weight loss has not been that extreme. I eat over 1,500 calories per day, and my diet is composed of the most nutritious foods on the planet. It's very carefully assembled to include sufficient fat (typically around 25% from nuts, seeds, and the veggies), along with plenty of starch and protein.

Thanks indognito. Sugar is definitely a worry point since the fruit is very high in fructose, but remember that fructose comes packaged with fiber so its effects are minimized. I appreciate your comment, but I do not think the weight loss is that extreme. The doctors who recommend this type of diet routinely see more dramatic weight loss in the initial period as your body readjusts to the new nutrient profile and more moderate caloric intake.

Thanks again for all these comments. I take them all to heart and mind, and will reevaluate all the evidence and suggestions as time passes. I've ordered a huge number of blood tests from HealthCheckUSA to see whats really going on and finally get a medically-controlled glucose test.posted by mmorelli at 8:05 AM on September 23, 2012

Yes, but I think the point is, there's a typo somewhere, because the difference from 243 to 231 is only 12.

Have you been ill at all over the past week or two? Even something mild like having a cold could alter your blood sugar levels.posted by treehorn+bunny at 8:23 AM on September 23, 2012

Missmagenta, weight loss has not been that extreme. I eat over 1,500 calories per day, and my diet is composed of the most nutritious foods on the planet. It's very carefully assembled to include sufficient fat (typically around 25% from nuts, seeds, and the veggies), along with plenty of starch and protein.

I'm not questioning your diet, merely stating that your reported weight loss is more than double what a typical person your age, gender and weight would expect to lose on the 1500 calories per day you say you're eating (and 3-6x the "healthy, recommended" rate of 1-2lbs per week and ). For you to lose 12lbs of fat in 2 weeks, eating 1500 calories per day your body would need to be burning around 4,500 calories per day. That is not normal for someone who does no exercise. It is more likely that you're dehydrated as that would explain both the rapid weight loss and the increased fasting blood glucose.posted by missmagenta at 8:24 AM on September 23, 2012 [3 favorites]

1- You need to eat more protein. I don't see (almost) any in that diet.
2- 98 before a meal and 150 after a meal seems a little high, especially with a diet as low calorie as that.
3- You are losing a LOT of weight in a short period of time. You should be in a calorie deficit, which should be causing low-ish blood sugars.
4- Get some ketodiastix. If you are putting out any ketones, go to a doctor.posted by gjc at 8:44 AM on September 23, 2012 [1 favorite]

By the way, my husband has diabetes type two. I am wondering why you are monitoring your blood sugar right now as he says that normal is anything under 150 (I am taking his word for it at the moment. ) Are you under a doctor's care for issues relating to blood sugar?

I do know that for him protein intake is very important and he is supposed to limit simple carbs. What you eat and what you eat WITH it matters. And exercise matters.

I still think that as wise as the hive mind is, for you in particular this discussion should be held with your doc, who will know YOUR physical condition and what these numbers might mean for you personally, particularly as it relates to the medication you are on. If your goal is simply to avoid diabetes, you really do need to get some exercise going.posted by St. Alia of the Bunnies at 12:26 PM on September 23, 2012

Low calorie does not lead directly to low blood sugar. You need to look at the macronutrient breakdown of what you are eating. You say that you are eating a pretty balanced ratio but to me it looks like you are eating way too much carbohydrate and not enough protein and fat to control your blood sugar. You may already know this but for the benefit of anyone who doesn't: Carbohydrates can be broken down by subtracting out the fiber to get the net carbohydrates. Once you do that you are left with primarily saccharides, or starches and sugars. The body converts much of this to glucose and your blood sugar is going to read higher.

If you want lower blood sugar (as a first step, then step 2 is to repair your insulin resistance if possible) you need to avoid sugar. Fruit and starch is high in sugar. Bananas, potatoes, powdered fruits, dates and dried fruits, apples and watermelon are total sugar bombs. I now have a relatively healthy blood sugar response after working on it a bit but I could not eat any of those foods in an amount more than a taste without consequences for my blood sugar numbers for a few days.

Additionally, an important part of digestion is chewing which secretes important digestive enzymes and also causes the body to secrete insulin to prepare for the incoming food. You are eating a lot of liquid, non-chew intensive foods and you're bypassing this process, hitting your body with a big shot of glucose without insufficient preparation and causing a flood of insulin to deal rather than a more gradual response. That's not going to help out your building insulin resistance problem.

On a personal note, as I mention above I've worked hard to lower my own blood sugar, both fasting and postprandial and I've found avoidance of carbs in any large amount to be crucial, especially at first to get insulin resistance under control. My most successful strategy has been to keep my carbs down below about 60 grams/day. This means that in my idea of a healthy diet I avoid all grains, starches and legumes and eat maybe 1 piece of low(er) carb fruit and a small amount of berries each day. Fruit is a treat, my desert rather than a central part of my diet. I have found adding in healthy fats to be a crucial part of any kind of lasting diet to allow for feelings of satiety. Activity does help, especially just after a meal by burning through some of the sugar in your bloodstream but if you can tweak your meals along with activity and your weight loss you'll get better results.

TLDR: Fruits and Starches are sugar. If you want to minimize your blood sugar you need to eat little to no sugar. As a starting point you should look at switching out the fruits and other carbs for lower carb vegetables and look more into how macronutrients in the diet affects blood sugar.posted by tinamonster at 12:28 PM on September 23, 2012

Two more notes: Bad sleep and stress can also raise your blood glucose levels so you can also make an effort to get 8 hours of high quality sleep and de-stress your life in an effort to control your numbers.

And to St. Alia of the Bunnies: Not to scare you or your husband, but you might want to look into your idea of healthy blood sugar further. There is quite a bit of evidence that there is damage to nerves, the brain, the insulin-secreting cells of your pancreas and other critical systems at blood sugar levels as low or lower than 140 mg/dl. The "healthy range" keeps going down with every revision by the ADA and it's more and more apparent that a healthy insulin response and good blood sugar control are just being better understood as a key marker of good health.posted by tinamonster at 12:36 PM on September 23, 2012

Also, get a new bg meter with fresh control solution to verify your bg meter hasn't started drifting.

You can buy the control solution but a meter is probably cheaper.posted by benzenedream at 1:41 PM on September 23, 2012

Okay, several responses have questions my macronutrient quantities. I calculated the values from my food journal, and the average is actually a bit higher than I thought. Here they are. These are total daily numbers:

Also, I'm rapidly becoming convinced that the real issue is the time of day that I'm measuring. I've read a lot here and elsewhere about the liver-related "Dawn Phenomenon". Usually, I wake up and immediately test my blood sugar before doing anything else and I get the range of values which you see above.

Today, this morning. I woke up and WAITED. I took a shower and cleaned some dishes--didn't eat or drink anything--and then, about an hour after I woke up, I tested my blood sugar.

READY??? It was 89!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

This Dawn Phenomenon results from the liver dumping glucose into the bloodstream as the organism it evolved to protect emerges from the fasting state we call refer to as sleep. But once I was up and active, the residual blood glucose was absorbed and normalized, and the glucose test revealed a level well within the fasting glucose normal range.

I dunno. It's one data point. I'm going to follow this regimen for the next several days and see if that was the issue.

Why are you breaking carbohydrates, fiber and sugar into separate deals? There are only three: fats, proteins and carbohydrates. And they should more or less be balanced with each other. Sugar and fiber belong in the carbohydrate group.

The fact that your blood sugar is all over the place depending on time of day still suggests that you have some insulin issues.posted by gjc at 3:41 PM on September 23, 2012 [1 favorite]

Just FYI, you should still see a doctor. Fasting bg of 126 is often considered diagnostic of diabetes. And 150 post-prandial (1hr or 2 hr?) may be, by some standards, acceptable for a diabetic, but it is NOT normal. And many endocrinologists -- and diabetics -- are now recommending far tighter control than the 180 number mentioned above. While pregnant as a type 1 recently, I was told to aim for <9>
Tl;dr: I think you're either diabetic or pre-diabetic already.9>posted by kestrel251 at 3:43 PM on September 23, 2012

Told to aim for <95 fasting and <120 1 hour postprandial. Don't know what happened there.posted by kestrel251 at 3:44 PM on September 23, 2012

So a really rough average of your macronutrient breakdown has you at 65% Carb, 15% protein, 20% fat. I just wanted to toss that out there so that you are aware that it is nowhere near an even distribution.

I am also of the same opinion as gjc and kestrel251 that blaming your high numbers on the dawn phenomenon is ignoring the other warning signs of a problem that, if you continue to eat as you are eating now, is likely to get worse, not better. I don't want to scare you away though because I think you are really on the right track.

When you are on a weight loss/ reduced calorie diet it's even more important to get the most nutrients possible out of the food you eat so you're going to want to look at food through the lens of carb content vs. nutrient density. You want to budget your carbs and use them on foods that give you the most of the vitamins, minerals, amino acids and antioxidants that are going to keep you healthy through your weight loss and life.

I think you are doing better than most people by keeping an eye on this stuff and I really commend your choices of real foods. So I think you could make a few small changes and come out way ahead. By monitoring your post meal blood sugars you will be able to understand your own personal carb tolerance, tweaking the content of your meals and aiming for 1 hour postprandial <1>
Specifically about the food you list:
- I see that you don't list any meat or animal products and I'm going to assume based on that a vegan diet. If you are not vegan or vegetarian you should consider adding in some pasture raised eggs, fatty fishes like salmon, mackerel, sardines and shellfish like oysters, clams or mussels as well as some high quality grass-fed (has more omega 3 fats) beef, lamb or game and ideally, although most people aren't into it, some livers from grass-fed cows or pastured chickens. Liver is like more vitamin than food with its great nutrient profile.
- Can you swap out the banana in your smoothie for an avocado? It will give you much less sugar and starch and will give you some healthy fat which should make it more satiating.
- I assume you are including the fruit powders as vitamin supplements but is there some reason you can't just add in a small amount of the fruits themselves, unrefined? Berries like blueberries, raspberries and similar are good choices because they are low carb for fruit and pretty nutrient dense.
- Can you use another butter rather than peanut butter? Peanut butter has a less than healthy omega fats ratio (too much omega 6 and not enough omega 3) and been used to cause Atherosclerosis in rats, rabbits and primates in the lab for decades and it is though to do this especially well due to its unique lecithin. Some suggested choices: Macadamia nut butter, sunflower seed butter. Even Almond butter is a better choice although it has drawbacks too.
- Your soup sounds really yummy. I'm not sure how much is potato. A little is ok but if you find yourself using a lot of potato you might want to mix in some zucchini, celeriac or some other tuber that has a lower carb and better nutritional offering. And can you sub the flax seeds out for a tbsp or two of coconut oil? Basically if you can slip in a bit of coconut oil in wherever you can, it's going to help you feel full and it's been found to really help with weight loss.
- Can you pick lower carb fruits for your snacks and/or add in vegetables as well? Celery sticks, broccoli florets, carrots and a few pieces of sliced apple (leave half of the apple for tomorrow) or half a grapefruit, half a peach or a small serving of cherries will provide you with a larger variety of nutrients and less sugar.
- Trail mix can be good in moderation, a handful here and there, but it also really falls into the treat category. But if I could change just one thing about your mix I'd say skip the dates because they are very carb heavy.

oops, that should read "aiming for 1 hour postprandial less than 120 mg/dl"posted by tinamonster at 6:31 PM on September 23, 2012

If you're using a home glucose meter, like a OneTouch or the like, you should know that their accuracy can be off by 10 or 20 percent. So the numbers you have posted are not necessarily reflective of your real values (which as others have said can also be affected by illness, dehydration, etc.).posted by chinston at 7:22 PM on September 23, 2012

Like a lot of people trying to make a health change, you seem obsessed with the numbers here. Not necessarily a bad thing, but again you are focusing on small differences in numbers produced by a tool that is not necessarily that accurate. I would suggest your try a different kind of data point: try testing two or three times in a row for several days. See what kind of range your meter is giving you when you test three times within a minute. You may find as much variation as you posted above.posted by freejinn at 9:37 PM on September 23, 2012

ALERT: Day 2 of testing out my "Dawn Phenomenon" hypothesis continues to confirm the assumption. I tested this morning the moment I woke up and got 120 mg/dL. Then I waited an hour, walked around the apartment, folded some clothes, showered, etc., then retested. The result was, once again, 85 mg/dL. I'm not saying all the critical comments about my diet are wrong...but this is working out pretty well.

I eat one of the most nutritionally dense, healthy diets conceivable my mankind. I'm not bragging: I got the diet suggestions from books and doctors who back up their suggestions with scientific journal references and epidemiological studies of their own.

I break up "carbs" (a useless reference to an enormous class of macronutrients) because my diet has an ENORMOUS amount of fiber in it (around 70 grams per day). Hell, I might start breaking down starch into "non resistent starch" and "resistent starch" and also break down fiber into soluble and insoluble. I might start breaking down sugars into their respective monosaccharides too, just for fun. They're all different...they are NOT the same.

@tinamonster: Thank you for such a great post. I am on a vegan diet, in the vein of Dr. Furhman, Dr. Goldhammer, Dr. Neal Barnard and Dr. McDougall (basically the VegSource crowd).

I am not sure how tasty a morning shake would be using an avocado. Is it good? I mean, where's the sweetness coming from? Also, wouldn't the avocado blow my daily fat intake out of the water?

Thanks again for all your suggestions. I don't think any of this is a problem. My random tests during the day and my post-prandial levels are totally normal. Accounting for the Dawn Phenomenon, my fasting blood glucose is totally normal.

I'll continue to post glucose levels.posted by mmorelli at 8:46 AM on September 24, 2012

I totally agree that there is more to carbs than just sugar. The great thing is that you have a blood glucose meter that you are proficient with and you can determine your own personal "carb tolerance" by testing after meals to see how it affects you. I have absolutely found that things do not behave predictably according to the numbers and there was some real surprises in my own testing of specific foods and meals.

I personally find avocados in shakes to be absolutely delicious. It gives it a really creamy, milkshake vibe and an easy on the tummy richness but the avocado doesn't contribute a strong flavor. If it is not sweet enough, throw in a small handful of whole berries. Lots of antioxidants, not too many carbs. I'm also assuming that your powdered fruits are kind of sweet so I'm thinking it would not take much to make it quite sweet tasting.

Fat intake: Well, it depends on your viewpoint here. I really want to talk about this a little bit because this was the biggest epiphany that this former vegan had, dietarily. This is also probably the most (in my opinion) misunderstood part of dieting. Carbs and to some extent protein, do not really give you long term satiety. They digest quickly and give you the quick, short term energy of glucose but you lack the enduring energy found in fat.

So I've seen and experienced that on a low fat diet you either feel hungry pretty often (every 2-3 hours) and are fighting off the urge to eat more or your daily calories slowly creep up as you lose that battle. But if you use your calorie budget more proportionally on fat, you will probably find that you feel more satisfied after a meal for longer. Again, in my own personal experience, as soon as I upped the fat percentage my daily calorie intake plummeted naturally while I felt full, satisfied and energetic.

You should experiment with this to see what you think. Nutritional results really do vary quite a bit from person to person so doing self-experimentation is the only way to find the best diet for you. You can try taking your allotted calories and tweaking your ratios a little away from carbs and towards fat for a week or two (or ideally, longer to really give your body a chance to adapt) and see how it makes you feel. Track your weight loss and especially keep an eye on your body composition (because you want to lose fat, not lean tissue) and other health markers, how you feel, etc, and see if you can find an optimal diet that makes you feel satisfied while giving you the weight loss results that you want.

Another critical point is that many vitamins are fat soluble. So if you are eating the best, most nutritious diet in the world, nutrient number-wise, but aren't getting enough fat to process those nutrients they are going to be wasted, down the drain. In addition to the general understanding of the mechanism, there was a recent study that you can google for that specifically showed that people need to eat vegetables with fat in order to take advantage of their nutrition.

Avocados are a great fat to add, as is coconut milk, oil and unsweetened coconut flesh. Coconut butter is also really delicious and can be mixed with unsweetened cocoa powder, another great food to have in your diet, for outstanding vegan truffles. You could wrap that around a pitted cherry or raspberry and I would choose that over a snickers every day of the week. Yum! Coconut water is a bit sugary and has no real fat so it falls into the carb category.

Another point is that if you want to eat some carbs that you know have a more negative effect on your blood sugar, do it right before some sort of activity. Then your body can burn the sugar that is in your blood stream on your activity at the same time as it is releasing insulin to deal with it so that your insulin response is less. Even just going for a walk after your meals is going to produce a positive outcome vs. doing no activity.

As to the "dawn phenomenon," you should look into what causes that. This is really some nerdy self-optimization that not everyone is into but since you seem to be thoughtful on the subject and have put a lot of effort into your diet I'll throw this out there. Dawn Phenomenon is not something that everyone gets and is not really a desirable thing to have going on so if you can modify your diet or lifestyle to keep your blood sugar as flat as possible within the healthy range at all times of the day and night you will be experiencing the least damage from insulin and blood sugar peaks and valleys. A couple of things to try: having a heavy carb or protein dinner is thought to be one possible cause but you should also look at stress and sleep quality as they can contribute. Again, this is really optimization stuff and can get really in depth but if you're into it, google around and see what you come up with.posted by tinamonster at 12:49 PM on September 24, 2012

My post-prandial levels are totally normal

No, they're not. See my comment above. But IANAEndocrinologist.posted by kestrel251 at 5:08 AM on September 25, 2012

Here are the nutrition facts for the food I mentioned above, for anyone interested:

I really like the spinach, avocado, cilantro, grapefruit, orange, jicama and almonds mix with just a squeeze of lime juice, a dash of olive oil and a sprinkle of chili powder. That's 379 calories, 28 grams fat, 34 grams carb. Or skip the orange and use the whole avocado and get 485 calories, 41 grams of fat, 31 grams carb and you will stay full longer and can probably eat a later lunch and skip your afternoon snack.

The great thing is that you can pre-chop most of this stuff all on one day and then in the morning it's just a matter of picking and choosing what strikes your fancy.posted by tinamonster at 11:19 AM on September 25, 2012 [1 favorite]

TINAMONSTER YOU ROCK! THANKS!posted by mmorelli at 7:26 AM on September 26, 2012

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